Despite inspiratory oxygen fraction measurement being regulated by law in the European norm EN 740, fatal errors in nitrous oxide delivery still occur more frequently than expected, especially after construction or repair of gas connection tubes. Therefore, if nitrous oxide is to be used further in a hospital, all technical measures and system procedures should be employed to avoid future catastrophes. Among these are measurement of the inspiratory oxygen fraction (F(I)O(2)) and an automatic limitation of nitrous oxide. Also all anaesthetists involved should be informed about repair or construction of central gas supply tubes. Additionally, more awareness of this problem in daily routine is necessary. Furthermore, a system of detecting and analysing errors in anaesthesia has to be improved in each hospital as well as in the anaesthesia community as a whole. Measures for a better "error culture" could include data exchange between different critical incident reporting systems, analysis of closed claims, and integration of medical experts in examination of recent catastrophes.
No interrelation between ET and the hypothalamic-pituitary-adrenal axis could be established by the ET, ACTH, and cortisol plasma levels. However, the significant correlation between perioperative ET and cortisol lends further support to the hypothesis of ET release by cortisol from vascular smooth-muscle cells. There is a net pulmonary clearance of ET in patients prior to CABG that is lost intra- and early postoperatively, but tends to be restored on the 1st day thereafter at an increased level.
Einleitung In der Bundesrepublik Deutschland starben nach Angaben der Todesursachenstatistik des Statistischen Bundesamtes im Jahr 2001 insgesamt 828 500 Personen (383 900 Männer und 444 600 Frauen). Bei nahezu 50 % der Verstorbenen wurde der Tod durch eine Erkrankung des Kreislaufsystems ausgelöst; ca. 90 % der Verstorbenen waren über 65 Jahre alt. Frauen starben häufiger an Kreislauferkrankungen, weil sie im Durchschnitt älter werden als Männer. Von den 71 000 Personen, die infolge eines Herzinfarkts verstarben, waren hingegen 55 % Männer und 45 % Frauen [1]. Fort-und Weiterbildung nach den Empfehlungen der DGAI und ÖGARI Rubrikherausgeber: Th. Standl, Hamburg (Redaktion) · R. Braun, Bruchsal · S. Fitzal, Wien · P. Schmucker, Lübeck
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